Articles: pediatrics.
-
Review Meta Analysis
Association between helicopter medical services for pediatric trauma patients and mortality: Systematic review and meta-analysis.
Helicopter emergency medical services (HEMS) have become widespread around the world. However, previous studies of the influence of HEMS on mortality were limited to adult patients only and showed inconsistent and heterogeneous results. This study aimed to examine the association between HEMS and mortality among pediatric emergencies compared to ground emergency medical service (GEMS). ⋯ Our systematic review and meta-analysis, which was limited to trauma pediatric trauma patients, revealed that HEMS deployment correlated with decreased mortality. Further research is necessary to more effectively measure the potential influence and applicability of HEMS for pediatric emergencies.
-
Pediatr Crit Care Me · Oct 2024
Meta AnalysisExtracorporeal Cardiopulmonary Resuscitation Use Among Children With Cardiac Disease in the ICU: A Meta-Analysis and Meta-Regression of Data Through March 2024.
Epidemiologic data on extracorporeal cardiopulmonary resuscitation (ECPR) use in children with cardiac disease after in-hospital cardiac arrest (IHCA) are lacking. We aimed to investigate trends in ECPR use over time in critically ill children with cardiac disease. ⋯ About one-fifth of critically ill pediatric cardiac patients experiencing IHCA were supported with ECPR, and its use significantly increased over time. This may partially explain the increased trends in survival demonstrated for this population.
-
Review Meta Analysis Comparative Study
A systematic review and meta-analysis of surgical approaches in pelvic fracture-associated urethral injury in children: Primary endoscopic realignment versus delayed urethroplasty.
The management of pediatric patients afflicted with pelvic fracture urethral injury (PFUI) remains a topic of ongoing debate and controversy within the realm of urology. There is persistent discourse concerning the optimal timing for intervention, specifically between immediate primary realignment (PR) and delayed urethroplasty via suprapubic cystostomy (SCDU). This study was undertaken with the objective of conducting a systematic review of the existing body of evidence, with a focus on comparing the outcomes associated with PR and SCDU as interventions for PFUI among pediatric population. ⋯ This study demonstrated that primary realignment procedure did not yield superior outcomes in terms of stricture formation, urinary incontinence, and rates of erectile dysfunction compared to SCDU in pediatric populations with PFUI. It is noteworthy that the predominant inclusion of non-randomized retrospective studies in this analysis introduces a potential for bias. Consequently, there is a pressing requirement for further high-quality research, notably prospective studies and randomized controlled trials, to bolster the robustness of the existing evidence base.
-
Review Meta Analysis
Enhanced Recovery After Surgery Pathways in Pediatric Spinal Surgery: A Systematic Review and Meta-Analysis.
Pediatric spinal fusion surgery is a complex procedure that poses challenges in perioperative management. The enhanced recovery after surgery (ERAS) approach is an evidence-based, multidisciplinary strategy to optimize patient care in an individualized, multidisciplinary way. Despite the benefits of ERAS protocol implementation, the role of ERAS in pediatric spine surgery remains understudied. This systematic review and meta-analysis aims to evaluate the current literature regarding pediatric spinal surgery ERAS protocols and their ability to decrease the length of stay, pain, time-to-stand, and complications. ⋯ ERAS protocol implementation can significantly enhance outcomes for pediatric patients receiving spinal surgery. Consequently, ERAS protocols have the potential to lower healthcare expenses, increase access, and set a new standard of care. Future research should be conducted to expand pediatric ERAS protocols to a diverse range of spinal pathologies and assess the long-term advantages of this practice.
-
Pediatric emergency care · Oct 2024
Meta Analysis Comparative StudyEfficacy and Safety of Intranasal Fentanyl in Pediatric Emergencies: A Systematic Review and Meta-analysis.
Intranasal fentanyl (INF) has gained popularity in pediatric emergency departments (EDs) as an effective alternative to intravenous morphine for treating acute moderate to severe pain. Intranasal fentanyl eliminates the need for invasive access, making it advantageous for patients with minor injuries. Our study aims to provide a comprehensive evaluation of the available evidence regarding the effectiveness and safety of INF administration in pediatric emergency wards, particularly compared with other treatment options described in the literature. ⋯ Our study assessed the effectiveness of INF compared with other analgesics in pain reduction. Intranasal fentanyl demonstrated superior pain reduction at the 15- to 20-minute point but showed no significant differences at 30 and 60 minutes. Intranasal fentanyl also had a more favorable adverse event profile, with a lower risk of nausea and vomiting than other analgesics. However, no significant differences were observed in dizziness and hallucination between the groups.